Auto Insurance Quote Request

When it comes to the auto insurance, we will need to get the following information in order to quote a policy:

Driver 1

(required)

NAME*

DATE OF BIRTH*

/
/

Driver 2

(optional)

NAME

DATE OF BIRTH

/
/

Driver 3

(optional)

NAME

DATE OF BIRTH

/
/

Vehicle 1

(required)

YEAR

MAKE

MODEL

VIN

USAGE

Vehicle 2

(optional)

YEAR

MAKE

MODEL

VIN

USAGE

Vehicle 3

(optional)

YEAR

MAKE

MODEL

VIN

USAGE

Address

(required)

STREET*

CITY*

STATE*

ZIP*

EMAIL*

PHONE*

Coverage

BODILY INJURY

PROPERTY DAMAGE

UM/UIM COVERAGE

MEDICAL PAYMENTS

COMPREHENSIVE DEDUCTIBLE

COLLISION DEDUCTIBLE

TOWING & LABOR

RENTAL REIMBURSEMENT

PAYMENT FREQUENCY

CURRENT PROVIDER

ADDITIONAL INFORMATION

3041 BERKS WAY

Suite 101

Raleigh, NC 27614

Phone: (919) 342-9732

Fax: (919) 241-1941

About Us

Harbor Trust Insurance is an independent insurance agency centrally located in Raleigh, NC, serving North Carolinians from Asheville, to Charlotte, to Wilmington and other surrounding areas.
We specialize in homeowners, auto, commercial, life, and disability insurance.
Representing over 20 competitive carriers, we can do the shopping for you, while providing a personal touch to each request.